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coloproctology

, Volume 41, Issue 2, pp 106–109 | Cite as

Primary open treatment of sacrococcygeal pilonidal disease

  • A. P. WysockiEmail author
Leitthema
  • 74 Downloads

Abstract

Background

Surgical management of sacrococcygeal pilonidal disease ranges from pit/sinus procedures through excision with healing by secondary intent to various flap techniques. Short- and long-term outcomes differ between surgeons and techniques.

Objective

An overview of primary open treatment of sacrococcygeal pilonidal disease, including technique, wound complications and recurrence is presented.

Materials and methods

Relevant articles were identified from PubMed.

Results

Of the three primary open treatment procedures (deroofing, marsupialization and wide local excision), marsupialization may have the lowest recurrence rate. Primary open treatment has a significant rate of non-healing as well as recurrence.

Conclusion

Primary open treatment is widely practiced but wound healing may be a challenge for the patient and recurrence a challenge for the surgeon.

Keywords

Pilonidal sinus Surgical flaps Wound healing Pain Recurrence 

Die primär offene Behandlung des sakrokokzygealen Pilonidalsinus

Zusammenfassung

Hintergrund

Die chirurgische Behandlung des sakrokokzygealen Pilonidalsinus umfasst multiple Techniken – von der Sinusexzision mit primär offener Behandlung bis hin zu verschiedenen Lappenplastiken. Kurz- und Langzeitergebnisse sind wesentlich vom Chirurgen und der von ihm angewandten Technik abhängig.

Ziel der Arbeit

Ziel der vorliegenden Studie ist es, einen Überblick über die Methoden der primär offenen Behandlung des Pilonidalsinus einschließlich Technik, Komplikationen und Rezidivraten zu geben.

Material und Methoden

Relevante Artikel sind aus der Datenbank PubMed entnommen und zusammengefasst worden.

Ergebnisse

Von den 3 primär offenen Methoden Entdachung, Marsupialisation und weit offener Exzision weist die Marsupialisation die niedrigste Rezidivrate auf. Bei der primär offenen Behandlung nach weiter lokaler Exzision besteht eine signifikante Rate an ausbleibenden Heilungen und Rezidiven.

Schlussfolgerung

Die primär offene Behandlung mit weiter Exzision wird zwar oft angewendet, kann aber in der Wundbehandlung eine Herausforderung für den Patienten und bei Rezidiven eine Herausforderung für den Chirurgen bedeuten.

Schlüsselwörter

Pilonidalsinus Chirurgische Lappen Wundheilung Schmerzen Rezidive 

Notes

Compliance with ethical guidelines

Conflict of interest

A. P. Wysocki routinely performs the Anderson modified Karydakis flap for primary and recurrent pilonidal disease. A. P. Wysocki was a sponsored speaker at the AcelityTM Asia Wound Forum in 2018. AcelityTM is a manufacturer of negative-pressure wound therapy devices.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryLogan HospitalMeadowbrookAustralia
  2. 2.Griffith Health Centre—G40, Gold Coast CampusGriffith University Medical SchoolGold CoastAustralia

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